Central and Peripheral Adiposity Had Different Effect on Disability in Centenarians

Associations of body mass index, waist circumference and the weight-adjusted waist index with daily living ability impairment in older Chinese people: A cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey

AIM

To investigate the associations of body mass index (BMI), waist circumference (WC) and the weight-adjusted waist index (WWI) with the impairment of activities of daily living (ADL) in older Chinese people.

METHODS

A total of 13 260 participants aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey were included in this cross-sectional study. BMI, WC and the WWI were calculated from measurements of height, weight and WC. Binary logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Non-linear correlations were investigated using restricted cubic spline curves.

RESULTS

In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between WC and WWI and ADL impairment, with adjusted ORs (95% CI) of 1.01 (1.00, 1.01) and 1.08 (1.03, 1.12), respectively. Meanwhile, participants with a high WWI had a higher risk of ADL impairment compared with those with a low WWI, with an adjusted OR (95% CI) of 1.12 (1.02, 1.23). Subgroup analyses showed that only the association between WWI and ADL impairment did not differ in any of the different populations. In addition, we found that BMI, WC and WWI were non-linearly associated with ADL impairment.

CONCLUSIONS

There are significant associations between WC and WWI and ADL impairment in older Chinese people. The findings show the ability of the WWI to serve as a comprehensive and effective indicator of obesity in older Chinese people and emphasize the importance of assessing WWI in screening and preventing ADL impairment in older people.

The relationship between sleep status and activity of daily living: based on China Hainan centenarians cohort study

OBJECTIVE

This study, based on the China Hainan Centenarians Cohort Study (CHCCS), aims to comprehensively describe the characteristic of daytime, night and total sleep duration, sleep quality and different sleep mode of Hainan centenarians and their associations with activity of daily living (ADL) functions.

METHOD

The baseline data of CHCCS was used. ADL function was evaluated the Bathel index, sleep quality was evaluated by Pittsburgh sleep quality index (PSQI), sleep status including daytime, night and total sleep duration as well as sleep quality and sleep mode. Multivariate logistic regression model was used to explore the association between sleep status and ADL disability and ADL moderate & severe disability.

RESULTS

A total of 994 centenarians were included in this study with the age range 100-116 years old. Compared with the centenarians who sleep 6-9 h at night and < 2 h in the daytime, the adjusted OR between sleep > 9 h at night and sleep ≥ 2 h in the daytime and ADL disability was 2.93 (95% CI: 1.02-8.44), and adjusted OR of ADL moderate & severe disability was 2.75 (95% CI: 1.56-4.83). Compared with centenarians who sleep for 7-9 h and have good sleep quality, centenarians who sleep for > 9 h and have poor sleep quality have an increased risk of ADL moderate & severe disability (OR = 3.72, 95% CI: 1.54-9.00).

CONCLUSION

Relation between sleep duration and ADL disability was more significant compared with sleep quality in Hainan centenarians. Poor sleep quality can aggravate the relationship between sleep duration and ADL moderate & severe disability.

Prevalence and risk factors of elder abuse in survivors of stroke: A cross-sectional study

Background and Aims

The understanding of the prevalence and risk factors associated with elder abuse in stroke survivors is currently lacking. Therefore, the objective of this study is to ascertain the prevalence and potential risk factors of elder abuse in stroke survivors, while also examining its correlation with insomnia.

Methods

In this cross-sectional study, a total of 485 stroke survivors aged 65 years and older, who received treatment at the Emergency department of Shunde Hospital, Southern Medical University, were subjected to face-to-face interviews using the questionnaire on elder abuse from the Third Survey on Chinese Women's Social Status. A logistic regression analysis was employed to examine the association between risk factors and elder abuse among stroke survivors.

Results

62.27% of the participants reported experiencing elder abuse, with 14.85% of them indicating suffering from more than two subtypes of abuse. Factors such as residing in nursing homes, lower income, and smoking were found to increase the likelihood of experiencing elder abuse and all four subtypes of abuse. Additionally, advancing age was associated with a higher risk of experiencing all four subtypes of abuse, although it did not affect the occurrence of overall abuse. It is worth noting that the self-reported prevalence of the four types of abuse by the elderly themselves was higher compared to the reports provided by caregivers.

Conclusion

Elder abuse is prevalent among stroke survivors, especially those who are residing in nursing homes, with lower income, and smokers. Elder abuse significantly increased the prevalence of insomnia in stroke survivors. Further research is needed to better explore effective measures to reduce the prevalence of elder abuse of stroke survivors.

Waist-to-calf circumstance ratio and cognitive function among Chinese older adults: Mediating roles of physical performance and social activity

Background

In light of the potentially detrimental effects of central fat and decreased muscle mass on cognitive function, it would be beneficial to learn more about the mediating mechanisms underpinning the association between the two. The purpose of this study is to determine the association between waist-to-calf circumstance ratio (WCR) and cognitive function, as well as to investigate whether physical performance and social activity mediate the relationship between WCR and cognitive function among older Chinese adults.

Methods

An analysis of 9,652 older Chinese adults was conducted during the 2018 wave of the Chinese Longitudinal Health Longevity Survey (CLHLS). The Mini-Mental State Examination (MMSE) and a self-reported scale were used to measure cognitive function, physical performance, and social activity, respectively. Multiple linear regression and mediation analyses were conducted.

Results

The findings suggest that a high WCR had a significant negative association with cognitive function (B = -0.535, 95% CI: -0.754, -0.317). Mediation analysis revealed that a high WCR influenced old adults' cognitive function in three ways: first, through the partial mediating effect of physical performance (B = -0.270; 95% CI: -0.340, -0.203); second, through the partial mediating effect of social activity (B = -0.035; 95% CI: -0.055, -0.017); and third, through the serial mediating effects of physical performance and social activity (B = -0.021, 95% CI: -0.029, -0.015).

Conclusion

The study results suggest the adverse impact of a high WCR on older adults' cognitive function, and the possible mechanisms of physical performance and social activity by which the association takes place. Multidimensional health and social interventions aimed at improving physical, social, and cognitive functioning among older adults with sarcopenic obesity are recommended.

Transitional Dynamics of Sarcopenia and Associations of Nutritional Indices with State Transitions in Chinese aged ≥ 50

OBJECTIVES

Sarcopenia's temporal profile can be regarded as a dynamic process with distinct states, in which malnutrition plays an important role. This study aimed to address two research gaps: sarcopenia's transitional dynamics and associations of nutritional indices with state transitions in community-dwelling Chinese adults aged 50 and older.

DESIGN

A prospective population-based cohort study.

SETTING

Community-based setting in western China.

PARTICIPANTS

The analytic sample included data from 1910 participants aged ≥ 50 in the West China Health and Aging Trend study between 2018-2022.

MEASUREMENTS

We defined three states: the initial normal state (normal muscle strength, physical performance and muscle mass), the worst sarcopenia state (low muscle mass plus low muscle strength and/or low physical performance) and the intermediate subclinical state (the other scenarios). The relevant measurement methods and cut-off points were based on the 2019 AWGS consensus. Using a continuous-time multistate Markov model, we calculated probabilities of transitions between different states over 1, 2 and 4 years; we also examined associations between nutritional indices and transitions, including body mass index (BMI), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST), albumin (ALB), geriatric nutrition risk index (GNRI), vitamin D (VitD) and prealbumin (PA).

RESULTS

For individuals in the normal state, their probabilities of remaining stable versus progressing to a subclinical state were 53.4% versus 42.1% at 2 years, and 40.6% versus 49.0% at 4 years. In the subclinical population, their 2- and 4-year chances were 60.2% and 51.2% for maintaining this state, 11.8% and 16.2% for developing sarcopenia, 28.0% and 32.6% for reverting to normal. For sarcopenic individuals, the likelihood of staying stable versus retrogressing to the subclinical state were 67.0% versus 26.3% at 2 years, and 48.3% versus 36.3% at 4 years. Increased BMI, CC, MAC, TST, ALB, GNRI and PA correlated with reversion from the subclinical state, among which increased TST, ALB and PA were also paralleled with reversion from sarcopenia, while decreased BMI, CC, MAC, TST and GNRI were associated with progression to sarcopenia. VitD was not significantly associated with any transitions.

CONCLUSION

This study reveals how sarcopenia changes over time in a Chinese population. It also highlights the usefulness of simple and cost-effective nutritional status indices for indicating state transitions, which can help identify individuals at risk of sarcopenia and guide targeted interventions within the optimal time window.

Relationship between obesity-related anthropometric indicators and cognitive function in Chinese suburb-dwelling older adults

Background

Studies relating obesity to cognition in older people show conflicting results, which may be explained by the choice of obesity indicators.

Objectives

This study aimed to investigate the relationship between obesity-related indicators and cognitive impairment, especially between different age or gender subgroups, and explore whether obesity-related indicators were related to specific cognitive domains.

Methods

This was a cross-sectional study on 1753 participants aged ≥ 60 years (41.0% men; aged 71.36 ± 5.96 years). Obesity-related indicators included body mass index (BMI), waist circumference (WC), calf circumference (CC), waist to hip ratio (WHR), waist to calf circumstance ratio (WCR), fat to fat-free mass ratio (FM/FFM). The Mini-Mental State Examination scale (MMSE) was used to assess cognitive function. Cognitive impairment was defined as a score ≤ 17 for illiterates, ≤ 20 for participants with primary school education, and ≤ 24 for those with junior high school degrees or above. Multiple logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were used to analyze and visualize the linear relationships.

Results

The prevalence of cognitive impairment was 18.77%. In the fully adjusted model, CC was negatively associated with cognitive impairment (OR = 0.94, 95% CI: 0.90−0.98). Further analysis showed that CC correlated positively with recall and place orientation. A higher FM/FFM was found to be associated with a higher prevalence of cognitive impairment (OR: 1.44, 95%CI: 0.88–2.35, P for trend = 0.029); this association was notable in women (P for trend = 0.002) and the oldest (P for trend = 0.009), and so did the potential effect of BMI on cognitive impairment (70–80 years: P for trend = 0.011; ≥ 80 years: P for trend = 0.013). No statistically significant association was found between cognitive impairment and WC, WHR, or WCR.

Conclusion

CC and FM/FFM were associated with cognitive impairment in older people. Future research needs to distinguish the effects of fat and muscle mass on cognitive function, with special attention to different ages and genders.